| NPI | 1669828331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 88039) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 88039) | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-07-19 |